The PGspot - Different Pages, Same Book: Love and Desire Discrepancy

What happens when one partner wants sex more...or less often than the other? In this episode, we dive into the complex, often unspoken world of sexual desire discrepancy. From common causes and emotional impacts to communication tips and ways to reconnect, we explore how couples can bridge the gap without blame or shame. Whether you're the higher-desire or lower-desire partner, this conversation offers validation, insight, and real strategies for navigating intimacy mismatches. 

If you want to learn more about sexual health, sexual dysfunction, or how to improve your sex life, follow me on Instagram at @thepgspot or check out my website at doctorpattyj.com for blogs and resources related to sex positivity and real talk about sexuality.  As as always, stay curious, stay empowered, and stay you.

Transcript

0:08

Welcome to the PG spot, where our goal is to take the X out of sex by breaking down the barriers that prevent open communication about sexual health. I'm Dr. Patty Jalomo a dual certified nurse practitioner, pelvic floor therapist, and certified sexual counselor. I'm here to provide expert insights, debunk myths, and empower you to embrace your sexual wellbeing. Whether you're looking for answers or simply curious, join us as we open up the conversation around sex, intimacy and everything in between. I want to take this opportunity to acknowledge that some content may not be appropriate for all listeners. I'm a huge proponent of honest and accurate information regarding sexuality. But I'm also mindful that this should be age appropriate. Therefore, if you are under 18, this may not be the podcast for you. Additionally, some of the language used in this podcast may be offensive to some listeners. Please take these things into consideration before going forward with your consensual participation in this podcast. The opinions expressed by myself or my guests are just that, and these opinions are neither expected or required to be shared by all listeners. The information that is provided is for educational and entertainment purposes only, and should not be mistaken for individual medical advice if you do find the information that we cover in the PG spot. Helpful. Interesting or informative. Please rate and review the podcast wherever you're listening from. If you think this information is important, I would love for you to share it with your friends or family. This is a great way to get the information out to more people. So thank you for listening and let's get on with the show.

Patty 1:47

Hey everyone. Welcome back to the PG spot. I'm Dr. Patty Jalomo, and today we are exploring a topic that affects more couples than you might think. Sexual desire, discrepancy, or when one partner wants sex more often than the other. In fact, research shows that up to 80% of couples will experience mismatched sexual desire at some point. So if you're going through it, you're definitely not alone today. We'll unpack why it happens, how it affects relationships, and what you can do to reconnect. There's so much to discuss, so let's get into it. Sexual desire discrepancy, also called SDD, is basically when two people have different levels of interest in sex. Maybe one person wants sex more often or in different ways, or even not at all desire. Discrepancy is not at all uncommon. In fact, it's the most common sexual complaint that I see in clinic. One in three couples report ongoing issues with mismatched desire and it not only affects a relationship as a whole, but can have a significant emotional impact on both partners. In a study from 2020 published in the Journal of Marital and Family Therapy, 65% of people in couples with desire discrepancy report feeling personally rejected. It is something that can be an issue for years before someone addresses it, and it can be one of the most common factors that leads to divorce. many couples wait six years on average before even seeking help for sexual issues. So let's talk about why it happens. Why does sexual desire vary so much? Well, it's rarely just about sex. It can be stress hormones, mental health, trauma, relationship satisfaction, or even side effects from medication. For example, antidepressants and hormonal birth control are two of the most commonly cited culprits in desired shifts. Also desire changes over time. After the first year or two of a relationship, studies show that the frequency of sex usually declines by 20 to 50%. That doesn't mean something's wrong, it means you're human. There's something termed new relationship energy And that actually has a physiological foundation. New relationship energy is that thrilling high that many people feel in the early stages of romantic relationships. And it's very much a neurochemical cocktail. It's not just in your head metaphorically, it's literally in your brain. So let's break down the physiological or neurotransmitter based drivers of new relationship energy. There are several important neurotransmitters and hormones behind this. The first is dopamine, and this is like the reward chemical. It creates feelings of pleasure, motivation, and craving. During early attraction, dopamine spikes dramatically. Your brain starts associating your new partner with intense pleasure and excitement. This is why you think about them constantly. It's the same neural pathway activated by cocaine or gambling, meaning that new relationship energy can feel addictive. Functional MRI studies show that people newly in love have activity in a dopamine rich reward center in their brain. So that feeling of deep desire for a new partner is very much chemically related. Next, we have norepinephrine or noradrenaline, and this is the energy and arousal booster. It increases alertness, heart rate, and emotional intensity. Norepinephrine fuels that buzzy. Jittery. Can't eat, can't sleep. Feeling it makes everything feel heightened. Even getting a text from a new partner feels thrilling. You feel energized, focused, and sometimes even anxious, but in a good way. Next is serotonin, and this is the mood regulator. It regulates mood, sleep, and appetite. Strangely, serotonin levels actually dropped during early romantic love, especially in infatuation stages. This dip can make you feel obsessive or preoccupied. In a 1999 study by Razzi and colleagues, they found a significantly reduced serotonin levels in new relationships and found that these levels were similar to those found in people with OCD. The next hormone is oxytocin, and this is the bonding hormone. It encourages closeness, trust, and attachment. Oxytocin is released during physical intimacy like cuddling or sex, and it deepens that emotional bonding even in the early stages of a relationship. Oxytocin is also the hormone that is released during breastfeeding. It stimulates the emotional bonding between mom and baby. Finally, to a lesser extent there is vasopressin. Vasopressin is considered kind of the monogamy molecule. It plays a role in pair bonding and loyalty, especially after orgasm. While there's more research in mammals, research in humans has shown it to be linked to behaviors like protectiveness and long-term commitment. So while these neurochemicals all play a role in that new relationship energy, it tends to fade after about six to 18 months when the brain returns to a more regulated state Giving way to more of a long-term bonding that is supported more by oxytocin and vasopressin. While it may be helpful to understand that sexual desire has a basis in neurochemistry, there's so much more to it. When I talk with patients about desire, discrepancy, or any sexual issue, it's important to look at it through a bio-psychosocial lens. Addressing the biological component is simply one piece of the puzzle. And that's why for many people starting on testosterone replacement, for example, doesn't always make it better. Some of the other things that were mentioned such as stress, trauma, relationship status, and communication also need to be considered and addressed. Stress can be a common factor in sexual health, Causing everything from decreased desire to inability to orgasm, and even erectile dysfunctions when we can't be present. And in the moment it's much more difficult to allow yourself to feel the sensations and relax into the moment. Learning how to be present, not just in the bedroom, but in everyday life. Activities can help lower stress levels and have a much better experience sexually. For example, when men are overly anxious about maintaining an erection, the stress and anxiety cause activation of the sympathetic nervous system or that fight, flight, or freeze environment. This creates physical issues that further exacerbate the problem, Such as channeling blood flow to the organs that are necessary for survival, like the heart and the brain. In order for an erection to occur, adequate blood flow is required in the penis. An erect penis isn't considered to be necessary for survival, so the blood flow is diverted to essential organs, thus leading to an inability to achieve or maintain an erection because the clitoris is basically the female chromosome equivalent to the penis. The same is true for female sensation and orgasm. So it's not only that stress makes it difficult to concentrate and focus on pleasure, it also plays a physiological role in how the body manages blood flow. Trauma is another huge activator of the sympathetic nervous system, so this is something that must be unpacked and dealt with in order to be in a good place sexually. Past abuse, shame caused by religious or cultural teachings, body image, trauma, these all can have a significant impact on how we view our sexuality and embrace pleasure. And then there's the social aspect of our relationships. How well do you communicate your needs to your partner? How comfortable are you discussing intimacy? How comfortable are you about introducing new things into your sex life? These can all contribute to desire discrepancy. So what can be done if desire discrepancy is affecting your relationship? I have found that one of the best things that couples can do for their relationship is to talk about sex frequently and openly. Having weekly or even monthly check-ins is so important to having a fulfilling relationship. What works for us today won't necessarily work for us tomorrow or next week or next year. We are constantly changing, and it's important to understand that conversations around sex and intimacy are not just one and done. Having open and honest communication creates intimacy that carries out in all areas of our relationships. So check in with your partner frequently. Prioritize these times and make it fun, like having discussions over a nice dinner out, or even just making a date to walk around the park or go on a hike. Many great conversations can come out of just spending that time together and creating space for growth. Another important thing to remember is that not everyone feels desire just right outta the blue. In fact, studies show that up to 70% of women experience responsive rather than spontaneous desire, meaning that they only start feeling it after touch or arousal begins. And that's completely normal. If everyone was always thinking about sex or had spontaneous desire, nothing would get done. Or conversely, if everyone had responsive desire, no one would initiate anything and our population would die off. So it's completely normal to have one or the other or both. There may be times when someone who typically has responsive desire will be more spontaneous and vice versa. This can ebb and flow changing over time. It can even change on an hour to hour or day-to-day basis. So just know that this is all completely normal and there's really nothing wrong with either. There's something called the willingness model that can be very helpful when someone is struggling with responsive desire or a mismatched desire is causing problems in a relationship. The willingness model is a major component of responsive sexual desire, so consider the following In neutral situations where you aren't yet feeling sexual, you may find that you're open to sexual contact even if you aren't necessarily feeling turned on. If you think about spontaneous desire as a microwave, that is immediately ready to go, think of responsive desire as an oven. It must be warmed up, but it can still make a delicious meal. So the willingness model involves asking yourself, am I willing to go turn on the oven rather than. Is the oven already on? Those are two very different questions. This framework can help us to move from a neutral context to a sexual context. The best way to think about the willingness model is to use a simple zero to 10 scale to answer the question, are you willing to see if your sexual desire will arise or respond? When you're at zero, you don't feel willing to try to create responsive desire, and that's okay. We all have days when we're stressed, overwhelmed, or just aren't feeling well. At the other end of the willingness scale is a 10, meaning that you feel open to physical engagement of some kind to create responsive desire. Keep in mind that a willingness level of 10 doesn't mean that you're already turned on, but simply that you're open to cultivating responsive desire. There are lots of potential ratings between zero and 10, so it's important to really consider what a five or six means to you think about what your midpoint is. For one person, it might mean a willingness to cuddle and then to evaluate additional physical contact from there. For someone else, it may mean a definite no for genital contact, but a yes for some other form of intimacy. Take time to reflect on what moves you back and forth on the scale. What moves you closer to a zero? These are your breaks, and what moves you closer to a 10. These are your accelerators. One benefit of the willingness model is that we can use it to self-assess, so it's important to think about your brakes and accelerators. So with your brakes. what are some things that get in the way of you being sexually responsive? Things like stress, financial stress, relationship stress, the kids going to school, getting groceries. These are all things that might be going through your head that really put a break on your physical intimacy. And then what are some of your accelerators? So what are some things that move you closer to wanting to be physical? it may be that when you come home from work, you just need to take time to wind down, maybe a massage, maybe a warm bath, anything like that that can put you more into the mood to be willing to find responsive desire could be considered your accelerators. One benefit of the willingness model is that we can use it to self-assess as well as to communicate with our partners about our level of willingness to sexually engage. It's important that we don't fixate on whether one partner is willing to have the type of sex that the other partner wants. For example, Some people are labeled as having quote unquote low desire if they don't frequently want intercourse. But what if they're interested in other types of sex? What if instead of asking the low desire partner to have more frequent intercourse, we consider asking the higher desire person to work on expanding their concept to sex. So when we're thinking about redefining what counts as sex, it could be things like kissing, cuddling, massage. These can keep the connection alive without pressure. An important component of the willingness model is that it is rooted in consent. Willingness comes from within. It cannot and should not be pushed for by a partner. It cannot be coerced, and is the underpinning for responsive desire? If it's not in an enthusiastic yes, then it's a no. Think about what your willingness scale looks like. Maybe take time to write this out from zero to 10, considering your breaks and accelerators, and then talk about it with your partner. What does their willingness scale look like? And what are some alternatives to intercourse that can be considered when thinking about your willingness skill? Finally, let's talk about scheduling intimacy. Look scheduled. Sex gets a bad rap, but it works. Knowing that there's space for connection, even if it's not always about sex, can relieve pressure and increase desire. think about other important things in your life that are scheduled, Such as going to the gym or even an appointment with your healthcare provider. It may not be something that sounds like fun to begin with, but they're important to your overall health. Just like sex is important to your overall relationship and happiness and like going to the gym, we may not be in the mood, but after we get there and start working out and getting those endorphins flowing, we usually find that we feel better and afterwards we're glad that we went. And the same can be true for sex, scheduled intimacy doesn't have to mean just penciling in sex every Thursday at 9:00 PM It could be much broader than that. Think about carving out time just for physical closeness without pressure. Maybe it's cuddling, a make out session, or even giving each other massages instead of seeing sex as a binary. Either you're having intercourse or you're not. Think of it more on a spectrum. Kissing, touching, eye contact, playful, flirting. These all can count. They maintain emotional closeness and make it easy to build towards sexual connection naturally. When the focus is on connection rather than performance, it can ease anxiety and actually rekindle desire. Another great thing about scheduling time together is that this is a great way to have those check-ins that we discussed before. Don't underestimate the power of open ongoing communication. The more a couple talks about sex, the better it can become. Mismatch Desire isn't a sign that something's wrong. It's a normal part of most long-term relationships. What matters is how you navigate it. Talk about what's working, what isn't, and how each of you feels. Not just about sex, but about stress, energy levels, connection, or even body image. Often mismatch desire is just the surface symptom of deeper emotional dynamics. At the end of the day, whether it's through scheduling, exploring different types of intimacy or opening up communication, the goal is the same. Creating a safe space where both partners feel seen and sexually connected, whatever that looks like for you. So in review, if you're experiencing a desire in your relationship, consider all of the factors that we've discussed. It's important to take that bio-psychosocial approach. So the biological. Is it a hormonal issue caused by menopause or andropause, which is the male equivalent to menopause? Female sexual pain due to vaginal dryness from lack of estrogen, or an inability to maintain erections for men are common biological issues. Review what medications you are taking and consider discussing that with your provider. For example, it's possible to transition to a type of antidepressant that doesn't carry so many sexual side effects, or a non-hormonal option of birth control. Finally, remember that there could also be a correlation with neurotransmitters, and there are medications like Banin, which goes by the brand name Addie or Bromide, which goes by the brand name vii. And these act on some of those neurotransmitters that we discussed. In reviewing the psychological aspect, consider how you or your partner were raised or any traumas that have been experienced. Did you come from a cultural or religious background where shame or stigma was attached to sex? And how is that serving you now? Are there outside stressors in your life such as work, finances or issues with your children that are affecting your ability to be present with your partner? And lastly, the social component that deals with how you show up in your relationship with your partner. How well do you communicate your needs? How comfortable are you about discussing intimacy? How comfortable are you about introducing new things into your sex life? Do you even like your partner or the sex that you're having? I joke about HRT, which for any of you menopausal women might recognize as hormone replacement therapy, but in this context it might be husband replacement therapy. But all joking aside, hopefully this isn't the first option that's considered. As we've discussed, there are so many things that contribute to decreased desire or desire, discrepancy. So if your relationship is important enough to do the work, these issues can be overcome, Desire discrepancy doesn't mean your relationship's broken. It means you're in a real evolving partnership. The key is curiosity over criticism and conversation over avoidance. Desire isn't static. It grows, dips shifts, and navigating that together can actually deepen your intimacy. So if this resonates with you, just know that you are far from alone and you can take steps to improve your sexual satisfaction. Thanks for listening, and until next time, stay curious, stay empowered, and stay you.

19:59

That's it for today's episode. Thanks for listening, and be sure to rate and review the podcast on whatever platform you're listening from and share it with your friends. That's a great way to help reach new listeners and make this a more sex positive world. Also, I'd love your feedback and questions, so send me a message. It's at email@doctorpattyj.com, and that's doctor spelled out, D-O-C-T-O-R-P-A-T-T-Y j.com. Until next time, stay curious, stay empowered, and stay you.